Hom Lisa A, Martin Gerard R
Children's National Heart Institute, Children's National Health System, Washington, District of Columbia.
Am J Perinatol. 2016 Sep;33(11):1072-5. doi: 10.1055/s-0036-1586108. Epub 2016 Sep 7.
Congenital heart disease (CCHD) is the most common birth defect. Screening for the most critical forms (CCHD) using pulse oximetry was added to the Recommended Uniform Screening Panel in the United States in 2011. Since then, CCHD screening has become nearly universal in the United States. Nurses are ideally situated to contribute to the development of best practices for implementation and provide education to families on CCHD screening. Much of the standardization, advocacy, and development of national recommendations occurred with key input from nurses. Nurses often have responsibility for educating parents, performing the screening, interpreting the screening algorithm, and the documentation of results. The nurse role often includes implementing follow-up quality improvement initiatives to ensure that systematic and accurate screening occurs. Smooth implementation can be achieved by identifying champions early, obtaining input from a multidisciplinary team including both physician and nursing leaders, and identifying ways to integrate screening into already existing workflow. By knowing the basics of why screening is important, how to screen, current recommendations on the follow-up for positive screens and the limitations of CCHD screening, nurses can advocate for their patients and positively impact outcomes for infants born with CCHD through early identification before discharge.
先天性心脏病(CCHD)是最常见的出生缺陷。2011年,使用脉搏血氧饱和度仪对最严重类型的先天性心脏病(CCHD)进行筛查被纳入美国推荐统一筛查项目。从那时起,CCHD筛查在美国几乎已普及。护士在制定最佳实施实践以及为家庭提供CCHD筛查教育方面具有理想的条件。许多标准化、宣传和国家建议的制定都有护士的关键参与。护士通常负责教育家长、进行筛查、解读筛查算法以及记录结果。护士的职责通常还包括实施后续质量改进措施,以确保进行系统且准确的筛查。通过尽早确定倡导者、获取包括医生和护理领导在内的多学科团队的意见,并确定将筛查纳入现有工作流程的方法,可以实现顺利实施。通过了解筛查为何重要的基础知识、如何进行筛查、当前关于阳性筛查后续跟进的建议以及CCHD筛查的局限性,护士可以为患者发声,并通过在出院前进行早期识别,对患有CCHD的婴儿的预后产生积极影响。